Healthcare Provider Details

I. General information

NPI: 1639063142
Provider Name (Legal Business Name): ELEVATE PROGRAMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2025
Last Update Date: 06/07/2025
Certification Date: 06/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 TERRACE WAY BLDG 4
GREENSBORO NC
27403-3671
US

IV. Provider business mailing address

4 TERRACE WAY BLDG 4
GREENSBORO NC
27403-3671
US

V. Phone/Fax

Practice location:
  • Phone: 336-312-8499
  • Fax:
Mailing address:
  • Phone: 336-312-8499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMILY TUTT
Title or Position: CEO
Credential:
Phone: 336-312-8499